Association of frailty with mortality in older inpatients with Covid-19: a cohort study

Aw, Darren; Woodrow, Lauren; Ogliari, Giulia; Harwood, Rowan

Abstract

Background: COVID-19 has disproportionately affected older people.
Objective: to investigate whether frailty is associated with all-cause mortality in older hospital inpatients, with COVID-19.
Design: cohort study
Setting: secondary care acute hospital
Participants: six hundred and seventy-seven consecutive inpatients aged 65 years and over
Methods: Cox proportional hazards models were used to examine the association of frailty with mortality. Frailty was assessed at baseline, according to the Clinical Frailty Scale (CFS), where higher categories indicate worse frailty. Analyses were adjusted for age, sex, deprivation, ethnicity, previous admissions and acute illness severity.
Results: six hundred and sixty-four patients were classified according to CFS. Two hundred and seventy-one died, during a mean follow-up of 34.3 days. Worse frailty at baseline was associated with increased mortality risk, even after full adjustment (p = 0.004). Patients with CFS 4 and CFS 5 had non-significant increased mortality risks, compared to those with CFS 1 – 3. Patients with CFS 6 had a 2.13-fold (95% CI 1.34 – 3.38) and those with CFS 7 – 9 had a 1.79-fold (95% CI 1.12 – 2.88) increased mortality risk, compared to those with CFS 1 – 3 (p = 0.001 and 0.016, respectively). Older age, male sex and acute illness severity were also associated with increased mortality risk.
Conclusions: frailty is associated with all-cause mortality risk in older inpatients with COVID-19.

Citation

Aw, D., Woodrow, L., Ogliari, G., & Harwood, R. (2020). Association of frailty with mortality in older inpatients with Covid-19: a cohort study. Age and Ageing, 49(6), 915-922. https://doi.org/10.1093/ageing/afaa184

• Journal Article Type: Article
• Acceptance Date: Jul 21, 2020
• Online Publication Date: Aug 10, 2020
• Publication Date: 2020-11
• Deposit Date: Sep 2, 2020
• Publicly Available Date: Aug 11, 2021
• Journal: Age and Ageing
• Print ISSN: 0002-0729
• Electronic ISSN: 1468-2834
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 49
• Issue: 6
• Pages: 915-922
• DOI: https://doi.org/10.1093/ageing/afaa184
• Keywords: longitudinal study, mortality, COVID-19, frailty, older adults
• Public URL: https://nottingham-repository.worktribe.com/output/4844241
• Publisher URL: https://academic.oup.com/ageing/advance-article/doi/10.1093/ageing/afaa184/5890511
• Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in Age and Ageing following peer review. The version of record, Darren Aw, Lauren Woodrow, Giulia Ogliari, Rowan Harwood, Association of frailty with mortality in older inpatients with Covid-19: a cohort study, Age and Ageing, Volume 49, Issue 6, November 2020, Pages 915–922, https://doi.org/10.1093/ageing/afaa184, is available online at: https://academic.oup.com/ageing/article/49/6/915/5890511.